Homelessness

Depression does not discriminate.  It affects everyone without regard to religion, culture, age, and gender, among many other categories.  Although depression is everywhere, today I want to focus on depression and homelessness, which can include many of its own challenges.

According to NAMI, around 26% of homeless adults staying in shelters live with serious mental illness.  Around 46% live with severe mental illness and/or substance use disorders.  This comprises a large number of the homeless population.  And you may wonder, what comes first?  Does someone with mental illness end up homeless, or does homelessness lead to things such as depression?  I am not sure if there is any solid data on it, but my guess is that it goes both ways.  To me, homelessness is a huge stress that may just lead to depression.  However, if you are so depressed you can’t get out of bed, you may end up getting kicked out of your living space.  Regardless, this is a serious concern.

Unfortunately, I can’t do justice when speaking about this topic, because although I think I might know what is going on, I may be very wrong.  What I do know, though, is that depression (or any mental illness) and homelessness requires more help.  How do we attend to their mental health needs when more basic needs are not being met?  Will the mental illness be improved by helping with basic needs?  There are a lot of concerns here, and I struggle to know what the answers are.  However, an important piece is to understand how prevalent this issue is.  Once we realize how much this is happening, we can start to talk about it and come up with solutions.

What do you think?  Did you realize there was so much mental illness in the homeless population?  What are your thoughts on how we can help this group of people?

Mental Health Month

As I write this post, we are starting the month of May.  In the United States, there are months and days for everything it seems, and one of the designations for May is Mental Health Month.  This has been happening for many years, and green is the color that has been chosen to go along with it.  As you can imagine, May will be a month in which there will be a lot of attention drawn to mental health, and people may see more ad campaigns and commercials on it.  Although I willingly signed up for the email lists, my inbox was flooded today from a variety of mental health organizations calling the month to my attention.

Sometimes I wonder why we need to call out issues with a special day or month.  After all, shouldn’t we be working on these things every day?  But, I understand it.  Of course, we are working on issues every day.  However, when we think particularly about May being Mental Health Month, it creates an extra layer of attention and effort towards the cause.  Simply bringing up the fact that “May is Mental Health Month” could be the beginning of many insightful conversations.  Ad campaigns and commercials may just be the inspiration that someone needs to seek help.  There are also probably many other ways that a heightened awareness can help people, and that is important.

If you are struggling with depression, maybe hearing about Mental Health Month will give you more hope than you currently have.  Maybe it will help you see that people really do care, not just in May, but every day of the year.  Were you aware of Mental Health Month before reading this post?  Regardless, are you interested in learning more?  I hope that the fact that Mental Health Month has become a major part of the calendar gives everyone some comfort that progress is being made.

Subtle Stigma

Although we are making progress, we still live in a world where there is a lot of stigma associated with depression and/or other types of mental illness.  Stigma can create a lot of shame for people who are suffering from depression and can keep them from getting the help they need.  Stigma can also ultimately reduce quality of life and may lead to premature death.  For the most part, I think that a lot of us understand the major aspects of stigma.  But what about the more subtle forms of it?

As an example that I have shared with many people, several years ago I was at a Motley Crue concert with my husband.  Alice Cooper was the opening act, a guy I consider to be a big “shock rocker” of the 1970s.  His set was going fine until he came onto the stage wearing a straightjacket, and he was trying to fight his way out of it.  People seemed to be entertained by it, but I was physically repelled.  A straightjacket?  This was not funny to me at all.  However, it occurred to me that even 10 or 20 years ago I wouldn’t have thought much about it.  Here was a more subtle form of a stereotype that was being perpetuated at a rock concert.

Some other examples come to mind.  Ever been to a haunted house that was portrayed as an “insane asylum”?  Ever used expressions such as “that’s crazy”, “that’s insane”, or “you’re crazy”?  Whether we realize it or not, there are subtle ways that the stigma of mental illness is still perpetuated.

Now, I’m not here to become the “stigma police” and shame people for these activities.  However, I want people to at least realize what these examples and others can mean.  Does it continue the idea that mental illness is scary and something to be feared?  Does it create more of a burden on people who want to seek help but are worried about how they will be seen?  Again, my ask here is to at least think about the subtle ways in which stigma is still alive and well in our society.  After all, recognition is usually the first step in solving an issue.

Other Nutrients

In my last entry, I discussed some of the main mineral deficiencies that may lead to depression or be a part of a combination of factors that cause depression.  Today, I want to touch on other nutrient deficiencies that may also lead to depression.  While again the list may not be comprehensive, it presents some common nutrients that are suspected of contributing to depressive symptoms.

The nutrients I will mention include: omega-3 fatty acids, a combination of the Vitamin B family, and Vitamin D.

Omega-3 fatty acids are very important for brain cell structure and function.  Omega-3 fatty acids can also help to reduce inflammation.  A lack of these particular fatty acids can lead to inflammation and brain cell issues, possibly leading to disease states such as depression.

There are many B vitamins (B1, B6, and B12 are examples) that are used in the body.  Many of these are a part of neurotransmitter creation and function, among other activities.  A lack of these vitamins can lead to mental health issues.  Of note, Vitamin B12 deficiency is well known for causing neurological and depressive type symptoms.

Vitamin D is used by the brain for many functions.  A lack of vitamin D can lead to depression or other mental health issues.  As a lot of people know, a good source of Vitamin D is sunlight.  If you live in colder climates, however, it can be hard to get enough Vitamin D in the fall and winter.

As I mentioned in my last post, if you have depression and are seeing a provider for it, consider asking them to test for these deficiencies or reviewing your diet to see about making some changes to your diet.  Again, supplements may also be considered.  Regardless, combined with looking at mineral deficiencies, this can be an easy way to address potential causes of depression.

Minerals

As I have mentioned before, there are a lot of ideas about what causes depression.  I have listed theories such as hormone issues, our diet, our environment, and genetics, among others.  It is thought that for a lot of people depression is the result of a combination of different causes, but today I would like to take a closer look at potential mineral deficiencies that may be linked to depression.

Although this is not necessarily a comprehensive list, a lack of the following minerals in the diet may lead to depression: iodine, selenium, zinc, magnesium, and iron.  Why are these minerals suspected to cause issues?

Iodine is an important mineral related to thyroid function.  If there is a deficiency in iodine the thyroid may not work as well, leading to things like a slower metabolism and depression.

Selenium is also an important mineral related to thyroid function, so a deficiency in selenium can lead to similar symptoms as what is seen with an iodine deficiency.

Zinc is important to many biochemical processes in the body, including those related to mental health.  A deficiency here can lead to mental health issues.

Magnesium is similar to zinc in that it is important to many biochemical processes in the body and can lead to mental health issues if deficient.

Iron is important to help carry oxygen in the blood.  A deficiency can lead to anemia, and symptoms can include a depression type of presentation.

If you have depression and are seeing a provider for it, consider asking them to test for these mineral levels to see if they might be playing a role in your depression.  If testing reveals deficiencies, changing parts of your diet might help your depression tremendously.  Or, testing might not be available or done at all, but a review of your diet could lead to making some changes.  Supplements may also be considered.  Overall, this might be a simple way to address a potential cause of depression that is commonly overlooked.

Mental Health First Aid

Most of us have heard about classes for CPR, choking, and first aid for physical wounds and injuries.  These classes provide a lot of helpful information and practice that can help save lives.  However, did you know that there are mental health first aid classes as well?

This idea is fairly new to me, and honestly I can’t believe I hadn’t heard about it before.  There are also probably several different ones out there, but the one I have heard about is called Mental Health First Aid.  You can find out more at their website, which is www.mentalhealthfirstaid.org  Essentially, these are classes that can cover both youth and adult mental health first aid.  The classes teach you how to work with someone who is experiencing a mental health or substance use crisis.  My assumption (since I haven’t taken it) is that they include both information and practice situations.  Much like the CPR and first aid classes, they can provide information that can help save lives.

After hearing about this, it made perfect sense to me.  If we have first aid for physical injuries, why not have first aid for the mental aspect?  As a result, I am working to set up a training that I can attend.  I have no doubt that I will learn skills that would be helpful for anyone to know.  After all, like CPR and first aid, we never really know when we might be called upon to help someone in either a physical or a mental crisis.

How about you – does first aid for mental health seem like a great idea?  Would you be interested in taking one of the classes I mentioned above?  What would you hope to learn in one of these classes?  For any of us touched by depression, I think these classes are worth considering.

Connections

When someone is depressed, that depression is connected to everything about the person.  It can affect what they do, where they go, how they feel, who they interact with, and many other factors.  Although depression does not and should not define a person, it will be tied to the person who is suffering from it.  Anyone else who is around that person will also feel a connection to the depression, but it might be felt in a variety of different ways.  The main point here is that depression has connections, whether someone wants them or not.

But there is good news.  When you really start to think about it, everything is connected.  This could involve a deeper philosophical conversation, but to keep it somewhat simple it is sufficient enough to say we are all connected as humans and what goes on in the world.  So, from that, if depression can be connected, then happy thoughts and actions are also connected.  If someone is depressed, seeing or hearing about a happy event can give that person connections to happier thoughts.

Of course, someone who is depressed may end up feeling even sadder that they could not experience the happiness for themselves or that they simply cannot feel much at all.  That is understandable.  But, the very act of witnessing or being exposed to happy thoughts creates a connection that can be so important.  It may not appear to help much in the moment, but the more happy and meaningful connections that can be made for a depressed person, the more a benefit is possible.

I understand this may all sound pretty vague, but overall the idea is that depressed people should be as connected to as much happiness and meaning as possible.  It may not be the absolute ticket to recovery, but it can help expose the depressed person to a more helpful way of experiencing life.

On the Go Counseling?

Recently, I have noticed that there are several services available where you can see a therapist via your phone or computer at times that may be more convenient for you.  The services vary in how often you can utilize it and how it is paid for, but the overall idea is that you can essentially have “on the go” therapy sessions when you need them.  Is this a good idea?

Honestly, I think it is too early to tell.  Like my earlier post on telehealth, this essentially runs into some of the same concerns.  These services really fall under telehealth anyway, but are even more flexible than some of the more formal ones set up by clinics and provider groups.  For example, my dad still went to a clinic to then look at a screen with his provider on it.  What I am talking about here is logging onto your computer or phone from wherever you might be to instantly have someone to “visit”.

Again, in some ways I think this is pretty amazing, and I have honestly thought about using a service just to talk to someone about shorter term concerns that I have.  That is the beauty of these services – they can be pretty short term.  However, if you have depression these off and on services may not be so great – it may be better to establish a long term relationship with someone you can actually see face to face.  Not to say this is impossible here, but it might be harder to do.  But, there is also the idea that something is better than nothing.  And, if your depression is really challenging and you don’t even want to leave the house or your bed, something like this may be the place to start.

What do you think?  Do these services add value in some way?  Would you consider trying them?  My guess is that this will continue to grow, so hopefully we will see more benefits than issues with these services.

Discontinuation Syndrome

A few posts ago I wrote about tapering antidepressants.  Right after I wrote this, there was a very good article in the New York Times on April 7, 2018, about withdrawing from antidepressant medications.  The article is entitled “Many People Taking Antidepressants Discover They Cannot Quit” by Benedict Carey and Robert Gebeloff.  As the title suggests, the article highlights people who have had issues with stopping antidepressants.  In fact, some people have had such trouble with stopping the medications that they have chosen to remain on them instead of dealing with the withdrawal symptoms.  What really struck me was that the term “discontinuation syndrome” was used.  Isn’t that just a fancy way of saying withdrawal?

Regardless of what you call it, there are many people who struggle with stopping antidepressants, even if the drug may not really be giving much of a benefit to the individual.  There is some research being done on tapering protocols, but the article also mentions that many people have taken tapering into their own hands and have tried to make it work for them without any help from a medical professional.  Of course, drug companies don’t necessarily have any strong desire to work on protocols to help people safely stop the medications they are selling.

I think this article is yet another call to think about what works for you as an individual, assuming you are taking antidepressants.  Can you stop an antidepressant without any issues?  Would you prefer to try a taper instead?  Perhaps the taper may take months or even over a year to complete – is that alright with you?  What side effects are you willing to accept and how long are you willing to accept them?  This article is further proof that antidepressants may not necessarily be the wonder drugs many people think they are.

Learning

While I have lived with someone who has had depression, I have not had depression myself.  Because of this, I can only speculate what it feels like to experience depression.  Also, I learn about it from the experiences of those who have went through it or are currently experiencing it.  Add to that that every person is unique and has different experiences.

One thing that I have found interesting is the stories of someone with depression talking about how they learned so much from the depression.  Is it possible that depression can teach you life lessons?  It may seem impossible or difficult when the depression is at its worst, but I believe that depression can give you lessons and gifts along the way.  Now, I am not saying this is a preferred way of learning about life, but I am inspired by the stories of those who have taken their history of depression and turned it into lessons learned and/or looked at some parts of it as a gift.

Again, I can only speak as someone who has seen depression but has not lived it, but from my angle I have learned a lot along the journey too.  Lessons about trust, loyalty, autonomy, dignity, compassion, and gratitude are just a few of many things I have really had to struggle with and grow as a person.  They did not come easy, and again, it would not have been the way I would have chosen to learn those lessons, but they are there and make me who I am today.  Although arguably easier for me to do, I have taken those experiences and tried to make myself and my world a better place in spite of it.

How about you?  Do you see depression as a way to learn?  Do you see that depression could be a gift in some way?  It may seem odd to think about it this way, but perhaps depression can give us some positives too.